Provider Demographics
NPI:1063404739
Name:WU, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:WU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1200 NW NAITO PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97209-2830
Mailing Address - Country:US
Mailing Address - Phone:503-219-8556
Mailing Address - Fax:503-274-5400
Practice Address - Street 1:2222 NW LOVEJOY ST
Practice Address - Street 2:SUITE 606
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-3033
Practice Address - Country:US
Practice Address - Phone:503-229-7554
Practice Address - Fax:503-274-5400
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2015-03-05
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Provider Licenses
StateLicense IDTaxonomies
ORMD18907207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR288086Medicaid
ORH24284Medicare UPIN
OR107631Medicare PIN
ORR107631Medicare PIN